| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURT ADVISORY GROUP3 Filed as: BURT ADVISORY GROUP (TO) | 307 S. MAIN STREET SUITE 302 ELKHART, IN 46516 | 4EVERLIFE INSURANCE COMPANY FORMERLY BCS LIFE INSURANCE COMPANY | $0 | $15K | $15K | 11.00% |
| NORTH AMERICAN BENEFITS COMPANY5 | 20 VALLEY STREAM PARKWAY SUITE 310 MALVERN, PA 19355 | 4EVERLIFE INSURANCE COMPANY FORMERLY BCS LIFE INSURANCE COMPANY | $0 | $11K | $11K | 8.50% |
| NORTH AMERICAN BENEFITS COMPANY5 Filed as: NORTH AMERICAN BENEFIT COMPANY | 20 VALLEY STREAM PARKWAY SUITE 310 MALVERN, PA 19355 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $10K | $10K | 10.96% |
| BURT ADVISORY GROUP3 Filed as: BURT ADVISORY GROUP (TO) | 307 S. MAIN STREET, SUITE 203 ELKHART, IN 46516 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $7K | $7K | 8.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANY, INC EIN 35-0781558 ASO | Claims processing; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $468K |
| ANTHEM INSURANCE COMPANY, INC. | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing Service code 12 | — | $115K |
| AON RISK SERVICES CENTRAL INC. | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | — | $25K |
| ANTHEM INSURANACE COMPANY EIN 35-0781558 ASO | Other fees Service code 99 | — | $17K |
| AON RISK SERVICES CENTRAL, INC. EIN 35-0781558 BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | 450 E. 96TH STREET SUITE 275 INDIANAPOLIS, IN 46240 | $0 |
| EXPRESS SCRIPTS, INC. EIN 31-1714795 EXPRESS SCRIPTS, INC. | Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $0 |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 2,596 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,600 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 1,026 | $60K |
| Life insurance | 4EVERLIFE INSURANCE COMPANY FORMERLY BCS LIFE INSURANCE COMPANY | 2,596 | $132K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 796 | $92K |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANY, INC. | 1,300 | $378K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,596 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.